Sue Johnson Gregory, principal consultant, and Tim Powlson, senior consultant, at Entec Si, discuss how the NHS can recover from the long-term impact of COVID-19
The COVID-19 pandemic has provided a catalyst for rapid change within the NHS, as it struggles to cope with a sudden spike in demand for healthcare services. However, to mitigate the long-term impact of coronavirus and meet patients’ future needs, it’s vital that it finds new ways to improve agility and collaboration across the organisation.
In recent months, an urgent need to step-up specific areas of capacity in the face of coronavirus has forced the NHS to introduce more efficient and effective ways of working. For example, the widespread adoption of virtual out-patient clinics and consultations has allowed healthcare continuity to be maintained for the most vital of services while keeping staff and patients safe.
In order to bounce back from COVID-19 and build resilience for any future crises, the organisation must continue driving value from existing improvements, as well as taking steps to become a more agile organisation in the long-term.
One of the most significant issues that the NHS needs to address post-pandemic is its long-term impact on workforce wellbeing. The need to redeploy large numbers of workers from other areas of the healthcare system onto COVID-19 wards at short notice, and with little specialist training, is likely to result in many staff needing psychological support. As well as the high levels of stress involved in working on the front line against the disease, some workers may also be balancing an unusual or inconvenient working pattern alongside the heightened demands of family life. For this reason, robust HR functions and appropriate psychological support mechanisms will also be vital to ensure that workforce wellbeing and productivity do not take a hit from coronavirus in the months ahead.
Routine hospital care
Another challenge facing the NHS is that of restarting routine care as the threat of the pandemic declines. In January 2020, before coronavirus took full hold in the UK, around 4.4 million patients were on the waiting list for routine hospital treatment – around one in six of these had already been waiting for more than 18 weeks. Further delays could result in patients’ conditions worsening, increasing the impact on the NHS in the long run. Finding ways to maintain a high quality of care, within more streamlined operating models or improved patient pathways, will be key to reducing this backlog. The use of multi-disciplinary or multi-agency teams will also accelerate decision-making and the delivery of patient treatment plans.
Improvements to patient consultation processes could also play a key role in getting NHS services back on track after the pandemic. For example, where suitable, a greater use of multi-disciplinary teams for routine patient consultations could promote a more efficient use of specialist resources. Similarly, in some cases, it may be possible to boost capacity by using virtual services for areas such as physiotherapy, allowing a number of patients to access physiotherapy exercises at the same time using a video link. To be successful, such changes must be built with patient care in mind; focusing on efficiency alone could have long-term implications for patients’ health, at an increased cost to the NHS.
This pressure to resume routine services comes against a backdrop of significant funding pressures. While a large source of NHS income is referrals from NHS Primary Care Trusts, much of this work will not have been possible during the pandemic. Healthcare trusts which have found it challenging to effectively manage government funds over the last few months may also see this reflected in tighter future budgets. This will increase the pressure to do more for less.
To get healthcare services back up and running in an affordable way, the efficient use of existing resources will be vital. For example, during the pandemic, agency workers often had to be called in to support NHS workers, at a high up-front cost to the organisation. Considering creative ways to build flexibility into the working arrangements of existing staff could go a long way towards restarting routine services, while increasing resilience for continued outbreaks of the virus or future crises. This may result in the need to take difficult decisions around staffing arrangements, in the face of an increased demand for care. For example, could trusts introduce seven-day week working or seasonal rosters, and are staff willing to be flexible about their rotas and place of employment, where required? NHS managers should also regularly take time to stand back and reflect in detail on how their trust’s operating system works, and whether it’s making the most efficient use of resources.
In order to bolster the NHS ahead of future healthcare crises and the current threat of resurgent COVID-19 outbreaks, it will also be important to regularly assess business continuity. This should involve promoting a culture of collaboration and encouraging workers to learn what different areas of the organisation do, rather than becoming dependent on a few specific individuals. This will help to stop key services from grinding to a halt in the absence of a key person, for example, due to illness. Specialist advisers can also support healthcare trusts in responding to future disruption by implementing clear and well-managed recovery plans.
To ensure any organisational changes deliver long-lasting benefits, effective communication with staff across all areas of the NHS will be essential. Messaging should clearly focus on three key elements; why the change is happening, what the change will be and how it will benefit the individual – be it staff member or patient. If healthcare workers clearly understand how improvements will benefit them and the patients in their care, they will be more likely to engage in the change process and make it a success.
The coronavirus pandemic represents an unprecedented challenge for the NHS, and it’s clear that it will take time to bounce back from its impact. However, by taking steps to ensure that resources are used efficiently and by encouraging a culture of collaboration, the organisation can restart routine services and become more agile and resilient in the future.